Angiogram’s R’ Us

I’ve been scheduled to have my follow-up angiogram in a couple of weeks. It’s to check that the stent (flow diverter) we placed in April is doing well. Then it dawned on me that it’s not only to check on the stent, but to also check to see if it is preventing more blood from getting into the aneurysm.

One would hope that a stent placed inside of another stent would finally do the trick, but with this particular aneurysm, you just never know. It has been a thorn in my side, or a thorn in my brain for 16 years.

Let the scanxiety begin!

Stents & Socks

FYI: These posts are half typed and half using the terrific keyboard dictation feature.

My family is the type that can find humorous moments during the darkest of times. Some may call that inappropriate, others may call it a coping mechanism. In our case, I believe it is the latter.

Like when we were at my grandfather’s funeral in an outside room waiting for the service to begin. My mom was using some Binaca Breath Spray, which was very popular at that time. However, she didn’t have the spray in the correct direction and instead of spraying inside her mouth…the spray went all over her cheek. My sisters and I saw it as it happened and we all got the giggles.

When my father almost died from a ruptured intestine, my sisters and mom and I spent over night in the hospital waiting room. To pass the time we counted ceiling tiles. Then when we knew he survived the surgery, we needed to stop at a store to get “supplies” to go to a hotel. Things like saline solutions for contact lenses…underwear, etc. We were so tired it was like a very slow march of zombies. As we caught the reflection of ourselves the glass of a display case…we got horribly silly. Awake for 24-hours was not. a good look.

After my father passed away many years later, my mom and I made our first public appearance at our church’s Maundy Thursday service. Mom wasn’t looking forward to all the sympathy faces and comments of expression from people, so our plan was to arrive late and sit in the back, but there were no seats available, so we had to sit closer to the front. One of us sang something “off” in one of the hymns and we got the uncontrollable giggles. As we were both trying to hide our giggles, the obvious shaking of our shoulders probably made it seem we were both crying…and that WOULD have been appropriate since my dad has just passed. Nope…we were giggling.

Well, long story short….I think my family of angels (dad, mom, and both sisters) had some fun with me on Wednesday after I was admitted to the hospital for my latest brain procedure: inserting a flow diverter/stent inside my existing stent.

After checking in and walking down to the radiology department, I felt something hitting the back of my knee/calf. My rain jacket wasn’t long enough to hit that area and I couldn’t figure it out. Turns out it was something INSIDE my pant leg – a SOCK that hung on in the wash apparently. I’m still shocked I didn’t notice it before leaving the house, in the car, or the walk from the parking lot to the hospital

I couldn’t believe it. Too funny and something my family would do. I promptly extricated the offending sock from my pant leg and handed it off to Dave where it kept it for safe keeping. It surely helped lighten the mood.

I’ve been to this area of the hospital many times and I was SO glad that Dave was allowed to come in with me this time. We arrived promptly at 11:45 and proceeded to the pre-op area where I was asked more questions and prepared for ROUND 4 on my original, biggest brain aneurysm.

As usual, the staff at Maine Medical Center were top notch. Highly attentive, hard working, and kind. I met with part of the team that would be assisting with my stent placement and we made sure to mention I had a history of becoming quite nauseous. They promptly ordered up a nausea patch and gave me pill as well. I can happily say both were highly successful.

Part of my team was Jack, who is a PA and Dave and I were happy to see him. He has attended our brain aneurysm support group many times in the past and I was happy to see a friendly face. He explained the procedure to us again and that he was very confident we’d get it all done today which helped ease my anxiety. And I was anxious….more in previous days than today. Having a stent placed inside of another stent wasn’t something I had heard a lot about it.

IV’s were set up, my groin area was shaved, I gave Dave a kiss, and off I went to the endovascular radiology suite. It’s a bright and busy area with a fantastic team of technicians. I was quickly put under and my next memory is of waiting up in the PACU (Post Anesthesia Care Unit.) recovery area hearing Dr. Ecker’s voice saying the procedure went very well. I guess Dave saw me briefly when they were moving me there, but I don’t remember

Afterwards I had to lay flat for two hours to avoid any issues with the groin incision site. Then another two hours in recovery. During the wait, my main nurse was able to take a much-needed 30 minute break. Elaine was filling in for her. While reading up on my case, she noticed I worked at Johnny’s and mentioned how much she “loved their magazine”. It gave me great pleasure to tell her I was the one responsible for the layout. She said she’d tell people she met the person who does the catalog.

Dr. Jack came by to check on me and talk about the procedure. He said the flow diverter placement went very well and there were no issues. Also gave me a brief cognitive exam and was pleased. I was finally able to eat something. I ordered up an egg salad sandwich that hit the spot and didn’t cause any nausea, thankfully.

My throat was very sore and my voice was raspy due to the intubation/breathing tube they inserted during the procedure. I didn’t have much pain, just discomfort at this point. As expected, the groin and head were the main offenders.

Even though Dave was allowed in the hospital, he was not allowed back to see my in the PACU. So, I called him on my cell phone. By the time I was transferred up to a room on the sixth floor neuro ward, it was 8pm and visiting hours were over. So, I wasn’t able to see Dave again that day. He ended up driving back home. I called him several times in the evening.

This area of the hospital was once very familiar to me. I spent almost 20 days here after my ruptured brain aneurysm in 2006. It was called the 608 ward back in the day. It was not my favorite place. Noisy, chaotic, and crowded. Since a remodel a few years ago, is it now a quieter, less chaotic place with private room and strong sliding doors. I felt like I was in a the Plaza compared to those days.

Once I got settled in and introduced to the crew assigned to my corner room, Brittany and J.J. I was starting to feel some pain. I ordered up a hot black tea with a Tylenol chaser. As long as the Tylenol took care of the job, I did not need the stronger pain meds that were offered.

The tea really hit the spot, but the caffeine may not have been the best choice at 8:30 in the evening. In addition to the offering of tea, the lovely compression wraps were also slapped onto my lower legs to help alleviate the development of any clots and keep the circulation flowing. I have a love hate relationship with these things. I know they’re needed, but they make sleeping difficult as the wraps expand like blood pressure cuffs every 30 seconds and they’re wired up to the end of the bed, so some movement is restrictive. I’m a side sleeper and they just weren’t playing nice.

I was still hooked up to one IV pumping fluids into my body, but hydration wasn’t an issue today. So, at some point during the night, due to my successful urination visits, the nurse removed that IV. It felt great to have the arm free again.

I had a surprise visitor at 9pm — Dr. Ecker! I never saw him prior to going under in the operating room but I did remember hearing his voice afterwards. He and Dr. Jack both went to speak with Dave after the procedure which I know Dave really appreciated. The docs mentioned it was a good decision to have the procedure done after getting in there and really seeing what was going on. Dr. Ecker explained to me again that he felt everything went very well, BUT that we’d discuss it in more detail on our follow up in two weeks. I will also be having an angriogram in 6th months to make sure everything has healed as it should. It was great to see him and I appreciated him coming to check on me at that hour. It was his birthday today as well.

My discomfort in the bed continued and I got very little sleep overnight. Brittany was terrific and I had some pudding early in the morning for my next round of Tylenol. They performed neuro checks every four hours. With the usual “what’s your name”, “where are you”, “smile for me”, “stick out your tongue”, “raise your arms”, “touch your nose” and some strength test with my arms and feet. I passed them all with flying colors. I even got the date right after midnight.

Sometime after 3am, I was able to finally sleep, but then was awakened at 4:30 to go down for a CT scan. I knew they were going to do the CT scan, but wasn’t expecting it quite that early. They had a wheelchair all ready for me and I was whisked down for the scan and 10 minutes later I was back in the room on the 5th floor.

I was wobbly on my feet and there were some sensations visually that were bothering me. Then right after the scan, I got an ocular migraine. Thankfully it lasted the usual 30 minutes and didn’t develop into something more. Perhaps the contrast die from the CT scan triggered it..or it was just…you know…my brain was fiddled with earlier the previous day.

As dawn broke, there was a shift change on the floor and I was introduced to Kellie. Then things started to happen in rapid succession. I called Dave and he was already in the car driving down to visit me for the opening of visiting hours at 8am. I ordered up a tasty breakfast of cinnamon French toast, diced pears, orange juice and hot tea which tasted like coffee. Boooo….

Then Jack came in and gave me even more details of the procedure and to see how I was doing. He drew me a diagram of the anatomy of my aneurysm and to show the funky curves of my arteries. The placement of the new stent fell a little short he said and it may or may not cause some issues later on. I really appreciated him taking the time to explain it all and the drawing he did.

Dr. Jack’s drawing with my text and color embellishments

Then he said the CT scan looked good and all reports back to him via the post-operative staff and the neuro ward crew looked great and that he’d put in the order for discharge. Yay!

The nurse raised the shade in my room. The sun was shining and I was reminded of the bigger, badder world out there as I noticed a window opposite me had a Ukrainian flag and a heart in the window. Yes, I just went through my fourth procedure on this one brain aneurysm, but there were people both sick and healthy around the world in much dyer situations. I am blessed.

I slowly got dressed, Dave went out to pull the car around, and off we went for the hour and a half drive home. The drive pooped me out so we just drove through the drive-thu for a quick meal. I got home, promptly said “Hi” to the kitties and crashed on my own bed for a 3-hour nap. Oh, and I enjoyed a GOOD cup of hot tea.

This is now Friday and I’ve had a slight setback with regards to discomfort, some swelling, and lack of sleep. And now there is abdomen pain I’m dealing with on top of head pain. My groin feels pretty good. Yes, my groin hurts after brain procedures. That’s how they access it.

OH, and when I was being moved from PACU to the Neuro Ward, I discovered I was missing one of the hospital-supplied socks I was given upon entry into pre-op. What was it about socks and this trip? I think it was my family of angels having some fun with me. Well played….well played.

I Am Lit

As I get prepared for my 2-year follow-up MRA this Friday, I was curious to see just how many angiograms and MRA/MRI’s my brain has had since 2006. Thankfully, I was able to get a pretty good handle on that number by simply searching this blog. I was surprised by the number…but not really.

CEREBRAL ANGIOGRAMS

I have had NINE cerebral angiograms which include three treatments that are performed using this same process: my initial coiling, then my stent placement, and recoiling were all performed using angiography.

A Cerebral angiography provides x-ray images of blood vessels in and around the brain, showing abnormalities like brain aneurysms.

PHOTO: John Hopkins Medicine

Typically a catheter is inserted into the femoral artery in the groin and threaded through the circulatory system to the carotid artery where contrast die is injected. A series of images are taken as the contrast agent spreads through the brain’s arterial system, then a second series as it reaches the venous system.

MRA/MRI

I have also had SEVEN MRA/MRI’s. Magnetic resonance angiography–also called a magnetic resonance angiogram or MRA–is a type of MRI that looks specifically at the body’s blood vessels. Unlike an angiogram, which requires inserting a catheter into the body, magnetic resonance angiography is a far less invasive and less painful test.


PHOTO: My brain bling via MRA imaging.

The frequency and type of follow-up procedures I receive hinge on the previous scan showed and what procedure was provided. We’re hoping I can continue just getting MRA’s, but if something unusual shows up, more angiograms may be needed. Angiograms are more invasive and risky, but they are the gold standard for getting the clearest images of my blood vessels.

I am blessed to have had such a great neuro team here in Maine and terrific health insurance coverage through work.

Here’s to more scanxiety.

Two-Year Checkup 2018

I had my two-year MRA last weekend. Another trip down to Scarborough. This time on a Saturday afternoon, which was unusual and nice. Less traffic and great parking! My choice of music was 80’s pop and the whole thing took less than 20 minutes. Bada bing, bada boom. They used a combo of ear plugs and then placed ear phones over that. So, the sound of the MRI machine was significantly muffled. Nice!

It’s amazing how your mind plays with your emotions during that period of waiting. Especially when a potential vacation could be derailed if things have changed dramatically and I was told not to fly. A lot was riding on my brain and it had been a longer stretch of time between checkups.

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So, today I finally got the results back and this report was good. Nothing had changed from two years ago and we’ll do it all again in two years. (2020!) I still have that remnant of blood getting in to the neck of my first brain aneurysm, but the fact it stayed the same is good. Do I think I’m free and clear of ever having any other issues? No, but for now…I’ll take it. And I’m glad I didn’t have to endure ANOTHER angiogram. I’ll have to go back and check out my blog to see just how many I have had since 2006.

I’m still a survivor.

Look out Scotland & Northern Ireland! Here we come!

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